Ashbaugh Beal · 2 weeks ago
Patient Eligibility Specialist
Albuquerque,NM,US
Full-time
Onsite
Entry Level
2+ years expAshbaugh Beal is seeking a Patient Eligibility Specialist to work under the supervision of the Outreach and Enrollment Program Manager or Health Center Manager. The role involves assisting patients in determining eligibility for healthcare funding programs and providing information about health insurance options available under the Affordable Care Act.
Law EnforcementLegalProfessional Services
Responsibilities
Provide accurate and impartial information to patients and the general public about health insurance coverage available to them and their families under the Affordable Care Act
Conduct outreach and education activities in clinics and in community settings and door-to-door (as appropriate) on weekdays, weekends and evenings, as scheduled, to meet community needs
Explain and assist existing patients and the general public with eligibility determination and application for various healthcare financial assistance and/or insurance programs, including all forms of Medicaid, Medicare, UNM Care, NM Health Insurance Exchange plans; Title X, BCC, CRC, Title V, and sliding fee discounts
Verify insurance eligibility for Medicaid, Medicare, and third party payors, ensuring that all documentation has been accepted by HSD or other agencies
Update patient records in the practice management system including income and insurance information
Provide information to patients and the general public concerning functions of FCCH, ensuring customer satisfaction and the highest level of customer service
Ensure that monthly quotas for enrollment are met and documented for grant reporting
Answer the telephone and connect callers to the appropriate offices or individual staff, as necessary. Refer callers to other agencies when FCCH cannot meet needs
Schedule appointments over the telephone and in person using the practice management system and other software as needed
Other Duties, As Assigned
Qualification
Required
High School graduate or GED certificate
At least two years related experience and/or training is required
Obtain within first 6 months of hire/maintain a Presumptive Eligibility Determiner Number
Comfort working with people one on one and in giving group presentations
Proficiency using the Internet and various software programs and computers
Proficiency using a laptop, wireless card, mobile scanners and cell phones
Good interpersonal communication skills and ability to establish a sense of trust while also maintaining professional relationship
Basic knowledge of health insurance and the health delivery systems
Ability to recognize and address barriers including cultural and language differences
Ability to summarize and explain complex information in different ways to meet different learning styles and needs of clients
Ability to work independently, and as part of a team, in the field and in office settings
Ability to manage time and priorities effectively and to meet deadlines
Ability to work on multiple tasks and to be flexible with schedule and assignments
Ability to work under the direction of a supervisor and follow detailed instructions
Ability to take the initiative to resolve patient concerns and problems
Ability to travel outside the county on a daily basis if needed
Knowledge and familiar with compliance program, corporate fully and comply with laws and regulations
Preferred
Bi-lingual English/Spanish
Company
Ashbaugh Beal
Ashbaugh Beal is a legal services company that specializes in construction law, corporate transactions, insurance recovery and litigation.
11-50 employees
Funding
Current Stage
Early StageLeadership Team
Annie Lombroia
Chief Results Officer and Director of Marketing & Business Development
Chris Ferrell
Partner
Recent News
Seattle TechFlash
2025-05-01
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